Q: I have just been diagnosed with hyperlipidemia. Before putting me on any medication, my doctor recommended that I try to make changes in my lifestyle in hopes that I can reduce my cholesterol on my own. My nurse told me that the Mediterranean way of eating can help reduce cholesterol. What is the Mediterranean diet and how can I incorporate it into my busy lifestyle?
A: Your nurse was on the right track. Increasing scientific evidence indicates that positive health effects, such as cholesterol reduction, results from diets rich in fruits, vegetables, legumes and whole grains and that include fish, nuts and low-fat dairy. Such diets also emphasize the use of vegetables oils rich in monounsaturated fats and low in saturated fats and void of products that contain hydrogenated and partially hydrogenated vegetable oils. These dietary patterns exemplify the traditional Mediterranean diet.
What is the Mediterranean diet?
The traditional Mediterranean diet refers to the dietary patterns typical in the early 1960's of some Mediterranean regions, including Crete and other parts of Greece and Southern Italy. The reason these dietary patterns are singled out are because the adult life expectancy of these areas were among the highest in the world; with rates of coronary heart disease among the lowest in the world during that time.
The Mediterranean diet is a centuries-old tradition that contributes to good health, provides a sense of well-being and pleasure and forms a vital part of the cultural heritage of these regions. These same practices can be adopted in our homes to enhance our well being and overall risk of heart disease and other chronic disease states.
The Mediterranean diet emphasizes the following:
- An abundance of food from plant sources. These include vegetables, fruits, breads, potatoes, cereals and grains, nuts, beans and seeds. Whole grain instead of enriched sources of breads and cereals are preferred.
- Minimally processed foods and whenever possible, seasonally fresh produce. Purchasing seasonally fresh produce maximizes retention of heart-disease fighting nutrients.
- Fresh fruit as typical daily dessert with foods containing refined sugars and saturated fats eaten only occasionally.
- Olive oil as the primary source of fat instead of butter and other undesirable fats. Olive oil is rich in monounsaturated fats, and when substituted for saturated fats, can reduce the bad (LDL) cholesterol.
- Total daily fat intake ranging from 25% to 35% of total calories ingested, with saturated fat no more than 7% of calories.
- Dairy products (primarily yogurt and cheese) consumed daily in moderate amounts (low and nonfat versions preferred).
- Fish and poultry consumed in low to moderate amounts. Recent research suggests that consumption of fish is favored over poultry because of heart-protective fatty acids present in most fish. Aim for 6 ounces of fish each week.
- Red meat consumed in very low amounts (a few times per month). Whenever possible, lean meats preferred.
- No more than four whole eggs (egg yolks) consumed per week.
- Wine consumed in low to moderate amounts, normally with meals. This equates to two 3 ½ oz glasses of wine for men, one 3 ½ oz glass for women.
- An added benefit to the diet of these Mediterranean regions - regular physical activity at a level that promotes a healthy weight and physical fitness.
So, how can you start incorporating these dietary patterns into your already-too-busy lifestyle?
Try some of the following tips:
- Replace vegetable cooking oil or animal fats with olive or canola oil. Both oils are rich sources of cholesterol-lowering monounsaturated fat.
- Choose rolled oats, barley, buckwheat or other whole grain cereal for breakfast.
- Substitute refined or white flour products with unrefined whole grain products.
- Have a bean and vegetable based soup for lunch instead of your usual routine.
- Add dried beans to your favorite casserole or dish, or use to replace your usual meat entrée at dinner.
- Round up seasonal fruits and vegetables to have available for a snack during your break or lunch hour.
- Enjoy fresh berries alone or with nonfat yogurt for dessert.
- Aim to have no more than 1 red meat meal per week, 2 poultry dishes and 2 or more fish entrees each week. Have plant-based meals on other days.
- Substitute egg substitutes or egg whites for whole eggs at breakfast and when preparing baked goods.
- Add 2 Tablespoons of your favorite nut to hot or cold cereal, stir-fry, salad, yogurt, pasta or rice dish or trail mix.
- Go for a brisk, 20–30 minute walk most days of the week.
Incorporating the Mediterranean style of eating into your lifestyle will provide you with new and exciting tastes, textures and foods. Try this quick recipe, chock-full of heart-healthy nutrients.
Spinach and Rice
Makes 6, ½ cup servings
- 2 pounds fresh spinach, rinsed and drained
- ¼ cup olive oil
- 2 medium white onions
- 2 small garlic cloves
- 1 cup long grain white or brown rice
- 2 tablespoons tomato paste
- 2 bay leaves
- 2 cups chicken stock (low-sodium preferred)
- salt and pepper to taste
- In a large saucepan heat olive oil over medium-high heat. Add onions, garlic and rice. Saute until onions are translucent. Stir in tomato paste and then add spinach, bay leaves, salt and pepper. Mix well.
- Pour in chicken stock and cover saucepan. Simmer on medium heat until rice is tender and liquid is absorbed. Remove bay leaves and serve.
For more information on a heart-healthy diet plan, please contact the Preventive Cardiology and Rehabilitation Program at 216.444.9353 and we can schedule a nutrition consultation.